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Outstanding Clinical Results

We're proud of the medical evidence demonstrating that our innovative care model is working to improve the health and quality of life of our members. Here is a sampling of the positive outcomes our programs are producing.


CCA One Care


For 2016, CCA One Care was the top-rated Medicare-Medicaid Plan in the country, according to the 2016 Medicare Advantage and Prescription Drug Plan (MA-PD) CAPHS survey.*


80% of total Massachusetts One Care membership is enrolled in the CCA plan.


In 2016, our One Care program ranked above the 90th percentile for Medicaid HMOs for these key performance measures of healthcare quality:

  • Access to preventive and ambulatory healthcare services
  • Adherence to antipsychotic medications for people with schizophrenia
  • Follow-up after hospitalization for mental illness within 30 days
  • Statin therapy for people with cardiovascular disease
  • Kidney monitoring in people with diabetes
  • Statin therapy and medication adherence for people with diabetes
  • Breast cancer screening
  • Medication management for people with Chronic Obstructive Pulmonary Disease (COPD)

Our Mobile Integrated Health (MIH) program reduces avoidable emergency room visits and hospital admissions for members with acute care needs.

  • More than 35% reduction in average cost of each member visit per month, down from $835 in 2015 to $536 in 2016
  • According to survey of 275 CCA members who received MIH care through July 2017, 84% were able to avoid an emergency room visit
  • 95% of MIH users through July 2017 agreed they knew everything they need to know about their diagnosis from the attending MIH paramedic, according to user survey
  • 100% of MIH users would be willing to use the service again in the future, according to user survey
 

 Our two community-based Crisis Stabilization Units successfully treat members with acute psychiatric crises, reducing the need for inpatient admissions.

  • 9% decrease in number of days members spent in psychiatric hospitals and inpatient settings per 1,000 members per month from 2015 to 2016
  • 97% of members at both locations rated their overall satisfaction as “good” or “excellent” in satisfaction surveys in 2016
  • Average per diem costs for CSU admission are $600 to $700 a day, versus average inpatient admission costs of $1,050 day, creating a 40% savings


CCA Senior Care Options


 CCA Senior Care Options received 4 Stars out of a possible 5 Stars on the 2018 Medicare quality ratings for overall plan quality.**


In 2016, our SCO program ranked above the 90th percentile for Medicare HMOs for these key performance measures of healthcare quality:

  • Access to preventive and ambulatory healthcare services
  • Follow-up after hospitalization for mental illness within 30 days
  • Follow-up after hospitalization for mental illness within 7 days
  • Persistence of beta-blocker treatment after heart attack
  • Statin therapy for people with cardiovascular disease
  • Eye exams for people with diabetes
  • Statin therapy for people with diabetes
  • Medication reconciliation after hospital discharge
  • BMI (body mass index) assessment for adults
  • Medication management for people with Chronic Obstructive Pulmonary Disease (COPD)

CCA Senior Care Options reduced hospital admissions and readmissions for members, based on data compiled by CCA:

  • Admissions declined from 555 per thousand in 2011 to 388 in 2016, a decrease of almost 30%
  • 30-day hospital readmission rate declined by 10% from 2011 to 2016

70% of SCO members are nursing home certifiable, yet live safely and independently in the community with the supports we provide.

 


Our innovative Life Choices Palliative Care program shows excellent outcomes based on data compiled between 2009 and 2017 by CCA:

  • Among SCO members who died between January 2009 and April 2017, over 55% died at home or in nursing homes rather than in a hospital
  • 64% of our SCO members have created advance directives
  • Average number of ICU days for SCO members in their last six months of life is only 1.6 days, compared to MA average of 3.6 days

*2016 patient survey, Consumer Assessment of Healthcare Providers and Systems (CAHPS), Centers for Medicare & Medicaid Services.
**Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.
 
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